Neal Smith National Wildlife Refuge - Environmental Education Feedback Form

OMB Control No. 1090-0011
Expires 08/31/2018

Neal Smith National Wildlife Refuge-Environmental Education Feedback Form
This survey will ask questions about the program your school attended at Neal Smith
National Wildlife Refuge. Please answer all questions with as much detail as possible.
Your feedback helps us improve our education lessons. Thank you!

Which lesson(s) did your class attend?

Please write the date you attended the lesson(s)

Overall, did the lesson(s) meet your expectations?
Yes
No

Please rate the quality of the lesson(s)
Very Poor

Poor

Average/ Fair

Good

Very Good

What was most useful or memorable for the students?

Paperwork Reduction Act Statement: We estimate it will take you 5 minutes to complete the survey, including time to read
instructions, gather information, complete, and submit the assessment. We will use the information to gauge audience satisfaction
with lessons, and to improve/make changes per audience suggestion. Your response is voluntary. We may not conduct or sponsor
and you are not required to respond to a collection of information unless it displays a currently valid OMB Control Number. You may
submit comments on any aspect of this information collection to the Information Collection Clearance Officer, U.S. Fish and Wildlife
Service, 5275 Leesburg Pike, MS: BPHC, Falls Church, VA 22041-3803, or you may submit comments via email at
[email protected].

OMB Control No. 1090-0011
Expires 08/31/2018

What could be improved?

What other information would you have liked to see covered in the lesson(s)?

After today's program, how likely are you to do the following?

Recommend the lesson to another teacher
Extremely unlikely Somewhat unlikely Neither likely nor
unlikely

Somewhat likely

Extremely likely

Participate in another partner teacher or partner school program
Extremely unlikely Somewhat unlikely Neither likely nor
unlikely

Somewhat likely

Extremely likely

Visit Neal Smith National Wildlife Refuge with your class outside the partner teacher or
partner school program
Extremely unlikely Somewhat unlikely Neither likely nor
unlikely

List any other comments or questions below

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Somewhat likely

Extremely likely